离子型对比剂对血小板聚集功能影响的探讨

Effects of ionic contrast media on platelet's function

目的:通过多种诱导剂测量血小板聚集率,观察对比剂与血小板聚集功能之间的关系,探讨其作用机制,进一步指导临床选择药物。方法:选择患者22例,年龄14～64岁。静脉注射离子型对比剂复方泛影葡胺注射液30 mL,在注射对比剂前(Time 1)、10 min后(Time 2)、20 min后(Time 3)抽取静脉血5 mL,分别采用肾上腺素、二磷酸腺苷(ADP)和花生四烯酸为诱导剂测定血小板聚集率。结果:花生四烯酸通道的检测中发现,Time 1血小板聚集率最低,Time 2血小板聚集率最高,Time 3血小板聚集率有所降低,但仍高于Time 1。统计学分析结果显示:Time 1与Time 2比较存在统计学差异,Time 1与Time 3、Time 2与Time 3比较未达到统计学差异。肾上腺素通道的检测结果表明,Time 1血小板聚集率最低,Time 2达到最高,Time 3血小板聚集率有所降低,但仍高于Time 1,但3组之间比较未达到统计学差异。腺苷二磷酸为诱导剂的血小板聚集率检测中,Time 2血小板聚集率最低,Time 3血小板聚集率最高,但3组之间比较未达到统计学差异。结论:离子型对比剂泛影葡胺通过花生四烯酸途径促进血小板聚集。

Objective： To study whether platelet aggregation function is associated with contrast media by measuring a variety of indue- ers. Methods： The study was performed in 22 patients. Ionic contrast media of compound meglumine diatrizoate were injected intra- venous. Blood samples were obtained at pre-injection（Time 1）, post-injection 10 minutes（Time 2） and post-injection 20 minutes（Time 3）. Platelet aggregations induced by ADP （10 I^mol/L）, arachidonic acid （10 Ixmol/L） and epinephrine （10 trmol/L） were determined. Results： The platelet aggregation induced by arachidonic acid was lowest at Time 1, highest at Time 2. Platelet aggregation at Time 3 was lower than that at Time 2 but still higher than Time 1. Multiple comparisons showed statistical difference between Time 1 and Time 2, but there were no statistical difference showed between either Time 1 and Time 3 or Time 2 and Time 3. The platelet aggregation induced by epinephrine was also lowest at Time 2, highest at Time 3. Platelet aggregation at Time 3 was lower than that at Time 2 but still higher than that at Time 1. But there were no statistical difference showed among three times. In the ADP-indueed platelet aggregation at Time 1 was higher than that at Time 2. But platelet aggregation at Time 1 was the highest among three times. But there were also no statistical differ- ence showed among three times. Conclusion： Arachidonic acid approach is the key way of platelet aggregation function influenced by compound meglumine diatrizoate.